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The Nugent Score is a Gram stain scoring system for vaginal swabs to diagnose bacterial vaginosis. The Nugent score is calculated by assessing for the presence of large Gram-positive rods , small Gram-variable rods , and curved Gram-variable rods. A score of 7 to 10 is consistent with bacterial vaginosis without culture. The Nugent Score is now rarely used by physicians due to the time it takes to read the slides and requires the use of a trained microscopist. Bacterial vaginosis diagnosis is done by evaluating the pH, the presences of Lactobacillus spp. versus a mixed flora consisting of Gardnerella vaginalis, Bacteroides spp, Mobiluncus spp, and Mycoplasma hominis. The Amsel Criteria for bacterial vaginosis includes pH, evaluating the presence of clue cells, white discharge and an odor of amines after mixing with KOH.